Children and Social Work Bill [HL]

Baroness Tyler of Enfield Excerpts

Wednesday 29th June 2016 Grand Committee

[The Earl of Listowel]

My Lords, I rise to speak to my Amendments 3, 31A, 36 and 37 in this group. They would all have the effect of extending duties to government departments, going beyond local authorities, in recognition of the role they play in the lives of looked-after children and care leavers. I should like to advance this by creating a comprehensive and tangible national offer for care leavers to lay the strongest foundation for their transition to adulthood.

With all the uncertainty in this country, in Europe and in the world at this time, there may be a silver lining; it may help us to gain some insight into the uncertainties experienced by these children. Their Chancellor and Prime Minister are either absent or unable to function. They have no idea from one day to the next where they are going to be. So when we feel uncertain about the leadership of our parties in this country and of our future, or if we fear that we have alienated our friends and neighbours, it may give us some understanding of what it feels like for a three, five or 10 year-old who is in a family in which the parents simply do not function; there is no leadership or guidance and tomorrow they may be we know not where. Perhaps we know to some extent the fear and anxiety that these children feel. If we do not intervene effectively by giving them guidance, leadership and a clear structure to their lives, they may go through their whole lives experiencing fear on a daily basis, unable to form relationships and function in the world. To some degree we are experiencing a lack of structure at the moment.

I welcome the commitment of the Government to putting for the first time corporate parenting principles into law. I see it as an important step in making sure that children’s best interests, life chances and future prospects are put at the core of decision-making processes. The Minister will be aware, however, that the corporate parenting role does not stop with local authorities, because all levels of government are corporate parents to children in the care system. My first amendment seeks to extend the scope of corporate parenting responsibilities to include central government departments. I heard what the noble and learned Lord, Lord Mackay of Clashfern, said about corporate parenting responsibilities, and perhaps it is unfortunate that I am using these terms. But I go back to what he said earlier in the debate today. What I am seeking, and I think what we all want, is to extend the duties more widely than just to local authorities. That will ensure that we all work together to get the best outcomes for these children.

Welcome steps were taken in the 2013 cross-departmental Care Leaver Strategy, which brought together for the first time government departments to consider the impact of their policies on care leavers. For instance, care leavers in the employment system are now flagged up to workers in jobcentres and employment agencies so that the staff know that they are dealing with a care leaver and need to exercise particular care. I pay tribute to the Government for that. The amendment provides us with an opportunity to further advance that progress.

My noble friend Lord Ramsbotham spoke of the need to work across different agencies. I would like very briefly to quote from my noble friend Lord Laming’s recent report on preventing the criminalisation of young people in care, In Care, Out of Trouble. He takes forward the theme of how we must work better together to improve outcomes. For instance, he says:

“The work must be driven by strong and determined leadership at national and local levels, taking a strategic multi-agency approach to protecting children in care against criminalisation”.

His first recommendation is that,

“commissioning and disseminating a cross-departmental concordat on protecting looked after children”,

is vital. So he very much embraces the principle of ensuring that all departments work together to protect and promote the welfare of these children.

Noble Lords engaged in this debate will be aware that more than 10,000 children aged over 16 left the care of a local authority last year to begin the difficult transition into adulthood. Not only are these young people beginning this journey but they are also finding themselves independent and often without the support network afforded by a family. This rapid accession into independence, coupled with a lack of a close support network, means that many care leavers are at particular risk of debt and financial hardship—two things that no parent would wish on their child.

In subsequent groupings my noble friend Lady Howarth of Breckland and I will discuss a national offer so that these children get better support as they move forward from care and face fewer financial worries. In the meantime, I commend these amendments to your Lordships and I look forward to the Minister’s response.

[Baroness Tyler of Enfield (LD)]

My Lords, I have Amendment 5 in this group and lend my support to Amendments 4 and 31, which are in very similar territory. The purpose of my amendment is simple and has already been alluded to—the new corporate parenting principles should apply also to commissioners of physical and mental health services for children in care and care leavers.

As we have already heard, Clause 1 introduces a set of principles to which all local authorities must “have regard” when carrying out their responsibilities in relation to children in care and care leavers. Like other noble Lords today, I very much welcome the introduction of these principles. They should help to ensure that, when local authorities make decisions about services and what is best for children, they have the children’s best interests—their health and well-being, their wishes, feelings and aspirations—at the forefront of their mind.

It was argued very strongly at Second Reading and has already been mentioned today that parents will always seek the best for their children and that the state should be no different. I do not think it is an exaggeration to say that most parents would move heaven and earth to ensure that their child is either in good health or receiving the treatment they need if they are physically ill or in mental distress. I believe that the corporate parenting principles should be extended to health commissioners, reflecting the vital role that these bodies play in shaping the lives and outcomes of children in care and care leavers. As we know, these children are much more likely than their peers to have poor physical, mental and emotional health. To give one example, children in care in England are four times more likely than the average child to have an emotional or mental health problem. That is an issue we will return to in a subsequent group.

As the Education Select Committee identified in its recent inquiry, health services are often not organised in a way that makes it easy for children in care to access. There is already evidence of targeted support being decommissioned because of financial pressures. Child and adolescent mental health services tend to be reluctant to assess or treat a young person until they believe that they are stable in their placement and that there is little risk of them being moved to another area. It is a similar problem, I have heard, with GP registrations. It very much affects access to the services that these children need. It is a vicious circle. Placement instability leads to poor access to services, higher levels of unmet need and poorer outcomes. We simply have to do something to break this vicious cycle. That is the purpose of this amendment.

I will finish by saying that I have listened very carefully, both at Second Reading and, indeed, to the noble and learned Lord, Lord Mackay, today about the need to ensure that the local authority responsibility as corporate parent is sharp, clear and undiluted, and is not made too complicated. I will not mind at all being told that I do not have the wording of my amendment right or that it is not in the right place and should be in a different part of the Bill; I just want these principles to apply to health commissioners, without in any way diluting the core, central responsibility and accountability of local authorities.

[Baroness Lister of Burtersett]

My Lords, I support Amendments 3, 31A and 36, which, as the noble Earl, Lord Listowel, said, seek to extend corporate parenting principles to central government departments in recognition of the role that they play in the lives of looked-after children and care leavers. I am grateful to the Children’s Society for its briefing on this.

Like other noble Lords, I welcome the Government’s commitment to placing corporate parenting principles into law for the first time, and see this as an important step in making sure that children’s best interests—a key principle—life chances and future prospects are put at the core of decision-making processes. Statistics for looked-after children highlight a situation requiring leadership from central government to improve life chances through accepting their responsibility as corporate parent. The Prime Minister has emphasised this a lot recently. I think that we were going to have a life chances strategy announced tomorrow, but that has been rather derailed now. For instance, we know that at least 38% of care leavers aged 19 to 21 are not in education, employment or training. Research by the Centre for Social Justice showed that 59% of care leavers found coping with the mental health problems referred to by the noble Baroness, Lady Tyler, very or quite difficult. The same survey by the Centre for Social Justice found that 57% of care leavers found managing money and avoiding debt difficult.

This cocktail of poor educational attainment mixed with mental health difficulties, low-paid work and difficulty with managing money should alarm us all. More importantly, it should compel us to do better for these young people by ensuring that all levels of government which make decisions about their lives should be required to consider their responsibilities as corporate parents.

Welcome steps were made in the 2013 cross-departmental Care Leavers Strategy, which for the first time brought together government departments to consider the impact of their policies on care leavers—so in a sense the principle has been established. Extending corporate parenting principles to central government is, I would suggest, the next logical step. I hope that the Minister will agree that there is no argument against this in principle. We might question the practical ways of doing it, but this is an opportunity which we must seize for central government to do its bit for care leavers by adopting the very corporate parenting principles that it is now rightly laying down for local government in recognition of the pivotal role that central government policies play in the everyday lives of care leavers.

--- Later in debate ---

[Lord Mackay of Clashfern]

Amendment 33 in this group is mine. In the natural parent system there are normally one or two people who are linked to the child, and that link continues. When children go into care, the difficulty is that the staff looking after the children are apt to be different from day to day and week to week, and certainly from month to month. My proposal is that when a child comes into care, a member of the local authority care staff should be appointed with a responsibility for the well-being of that child. When I use the phrase “well-being”, I am thinking of course of the Care Act and the wonderfully large coverage that that phrase embraces. It is extremely important that this should happen.

Inevitably, there will be a need for change from time to time. I have therefore proposed that where it has to be changed, a new appointment is made so that there is always some individual responsible for the well-being of that child. An example of where this can happen and be important is in relation to the provision for the child. If a child is being provided for in a certain situation and it appears that a more inexpensive arrangement can be made for that child’s care, the idea might be to move that child from the more expensive arrangement to the less expensive. It is important that someone with responsibility for the well-being of that child should have an opportunity to be involved in that kind of decision. That seems to be well worth while.

The noble Lord, Lord Harris of Haringey, in his report on deaths in custody, suggested that where a vulnerable person came into the custody system it was important that a single person should have responsibility for looking after the well-being of that vulnerable person. I do not think the Government have actually refused to accept that particular proposal but they have not accepted it as yet. What lies behind that proposal is very much the same as what lies behind mine and I hope the Government will accept both.

[Baroness Tyler of Enfield]

My Lords, I have Amendments 34 and 87 in this grouping. I shall deal with Amendment 87 first, for reasons that I hope will become obvious. Both amendments are to do with the mental health and emotional well-being of children in care. I support much of what has been said and proposed in this very wide-ranging grouping; there are many very important issues being dealt with here.

At Second Reading I argued that the bedrock of promoting the mental health and emotional well-being of children in care should be the introduction of an improved system of mental health assessments for children entering care, throughout their time in care and indeed when leaving care. I acknowledge the work that is going on. The Minister has already referred to the current pathway that is being developed by the Department for Education’s expert group. It is indeed promising. However, that does not negate the need for a statutory strengthening of current mental health assessments.

Current statutory guidance states that children must receive a physical health assessment when entering care, whereas it is recommended that their emotional well-being should be evaluated by what is called a strengths and difficulties questionnaire. That is widely regarded as inadequate. The latest figures I saw suggested that around only 70% of children in England entering care had these questionnaires completed for them. As we have already heard this afternoon, children entering care often exhibit challenging behaviour resulting from their experiences before entering care, usually to do with abuse and neglect. Moreover, these questionnaires are completed by foster carers, who I am sure are doing their absolute best but who may have little or no training in mental health.

The point of my amendment is that these assessments really should be conducted by professionals with specialist knowledge of the therapeutic needs of children in the care system and how they should be met. The point I most want to emphasise is that the introduction of these mental health assessments for children in care is the first and most basic step towards improving their mental health. However, it is only that. They are a mechanism and not an end in itself. We want to see that these assessments ensure that children in care receive the right support and interventions to deal with their mental health and emotional needs.

This could include a range of things, such as peer support, group working, play or art therapy, counselling or a referral to CAMHS. I was encouraged to hear the Minister say earlier in the debate that access to CAMHS should be based on clinical need. That is absolutely right. However, at the moment, there is precious little evidence that that is happening.

The Minister also quite rightly raised Future in Mind, an excellent report that holds much promise if it is implemented properly. However, recent research by the NSPCC about the local transformation plans, which are the mechanism for implementing Future in Mind, reveals that just 14% of plans contained an adequate needs assessment for children who had been abused or neglected. There is a lot more to do.

As to Amendment 34, much of what I have already said applies. The amendment would introduce a duty to promote children’s physical and mental health and emotional well-being, including a requirement for a designated health professional. Currently, clinical commissioning groups are required to have access to the expertise of a designated doctor and nurse for children in care, whose role is to assist commissioners in fulfilling their responsibility to improve the health of children in care. However, this is not underpinned by primary legislation.

The duty to safeguard and promote the welfare of children in care should also include a particular duty to promote that child’s physical and mental health and their emotional well-being in line with the existing requirement to promote the child’s educational achievement. The two are inextricably linked; a point that was made very clearly by the noble Lord, Lord O’Shaughnessy. All the research tells us that levels of well-being impact on educational attainment and can predict future health, mortality, productivity and income outcomes. There is an awful lot at stake here.

The effect of this amendment would be that all clinical commissioning groups must appoint at least one person who is a registered medical practitioner or registered nurse who will be required to discharge this duty, building on the existing role of the designated doctor. This would put the requirement for the appointment of a designated health professional on the same statutory footing as the requirement for local authorities to appoint a virtual school head and a designated teacher. I see this as another piece of parity of esteem.

--- Later in debate ---

We have covered a lot of issues in this group of amendments. In the light of my comments and those made by the noble Baroness, Lady Howarth, about how putting all these things on the face of the Bill would restrict local authorities’ ability to think through where there is greatest need and how we should share good practice, I hope that noble Lords will be prepared to withdraw their amendments.

[Baroness Tyler of Enfield]

Given the strength of feeling that has been expressed on all sides about the mental health amendments in particular, would the Minister be prepared to agree to a meeting for those of us who tabled those amendments, and other Peers who have spoken with such passion on the subject, between now and Report?

[Lord Nash]

With pleasure.